| Publication: | A systematic evaluation of the effect of temperature on coagulation enzyme activity and platelet function | ||
| Reference: | Wolberg AS, Meng ZH, Monroe DM, 3rd, Hoffman M. A systematic evaluation of the effect of temperature on coagulation enzyme activity and platelet function. The Journal of trauma. 2004 Jun;56(6):1221-8 | ||
| Abstract: | Background: Hypothermia is associated with an increased risk of bleeding and is a significant contributing factor to the morbidity and mortality of trauma and complicated surgical procedures. A core temperature of 33 degrees C is associated with a significantly increased risk of death after trauma compared with 37 degrees C. Hypothermia-associated bleeding has been hypothesized to result from dysregulation of enzymatic function, reduced platelet activity, and/or altered fibrinolysis. Methods: We systematically evaluated the effects of temperature on isolated pro- and anticoagulant enzyme processes and platelet activation and adhesion. We also evaluated the effects of temperature on complete coagulation systems (activated partial thromboplastin time and an in vitro, cell-based model of coagulation). Results: Enzyme activities were only slightly reduced at 33 degrees C versus 37 degrees C, and this reduction was not statistically significant (p > 0.05). Platelet activation was also not significantly reduced at 33 degrees C versus 37 degrees C. Conversely, platelet aggregation and adhesion were significantly reduced at 33 degrees C compared with 37 degrees C (p < 0.05). Below 33 degrees C, however, both enzyme activity and platelet function were significantly reduced. Conclusion: Our results suggest that bleeding observed at mildly reduced temperatures (33 degrees - 37 degrees C) results primarily from a platelet adhesion defect, and not reduced enzyme activity or platelet activation. However, at temperatures below 33 degrees C, both reduced platelet function and enzyme activity likely contribute to the coagulopathy. | ||
| Publication Type: | Human experimental study | ||
| Low Risk of Bias: |
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| Risk of Bias Score: | 6 | ||
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Evidence Browser: Source: WolbergEtAl2004